急性白血病病例报告

AcuteLeukemia

097805郑志博Case:Amalepatient,40Yearsold,hasassociatedwithbleedingtendencyfor10days.Hecametoourdepartmentfordiagnosis.Case:Hehadfeverwithoutobviouscause10daysago,38.2℃,bodyaches,mildcough,alittlewhitesputum,alsofoundgumsbleedingwhenbrushingteeth,hadabnormalbloodtestatlocalclinic(unclear).Anti-coldmedicinewithouteffort,poorsleep,urineandstoolarenormal,noobviouschangeinbodyweightHistoryrecordHealth,nohistoryoftuberculosis(TB),nohistoryofdrugallergy.Notaddictedtoalcohol,tobacco,nosimilarfamilymedicalhistoryPhysicalexamnationT38.2℃，HR98per/min，RR20

per/min，BP120/80mmHgShowedacutehotillface,chestandlowerlimbskinhadscatteredbleeder,superficiallymphnodeuntouched,sclerawithoutstainedyellow,pharyngealhyperemia(+),tonsils(-).Sternalpresspain,lungpercussionnaormal,rightlunglowerlobehadmoistrales,abdomenflatsoft,liverandspleenuntouchedundertherib,lowerlimbsarenotswollenLaboratorytestsHb95g/L，Ret0.5%，WBC3.8×109/L，Blasts48%，PLT30×109/L；urine(-),stool(-)Question(1)ThiscasewhatisthemostlikelydiagnosisDiagnosisisbasedonwhat

(2)Describethediseaseswithwhichcasesshouldbeidentified(3)Whatothertestsshouldbeused(4)Describethetreatmentofthiscase.Answers(1)diagnosis:Acuteleukemia.Diagnosisisbasedon:fever,anemia,，Blasts48%>20%，PLT30×109/L

<60×109/L(2)ThiscaseneedtoidentifiedwithMDS,AA,ITP,IM,leukemoidreaction.(3)cytochemistryImmunologicaltest,chromosomeexamination

急淋急粒急单过氧化物酶（POX）（—）分化差的原始细胞（—）～（＋）

分化好的原始细胞（＋）～（＋＋＋）（—）～（＋）糖原反应（PAS）（＋）成块或颗粒状弥漫性淡红色（—）/（＋）颗粒细而散在（—）/（＋）非特异性酯酶（NSE）（—）NaF抑制不敏感（—）/（＋）能被NaF抑制（—）/（＋）碱性磷酸酶（ALP/NAP）增加减少或（—）正常或增加

(4)Thiscasetreatmentmeasuresinclude:generaltreatment

Chemicaltherapy:ALL:DVtherapy,AML:DA,HA,HOAPtherapyBonemarrowtransplantationSupportivetherapy:Preventinfection,correctionanemia,controlhemorrhageandmaintainnutrition.Thankyouforlistening.1、字体安装与设置如果您对PPT模板中的字体风格不满意，可进行批量替换，一次性更改各页面字体。在“开始”选项卡中，点击“替换”按钮右侧箭头，选择“替换字体”。（如下图）在图“替换”下拉列表中选择要更改字体。（如下图）在“替换为”下拉列表中选择替换字体。点击“替换”按钮，完成。132、替换模板中的图片模板中的图片展示页面，您可以根据需要替换这些图片，下面介绍两种替换方法。方法一：更改图片选中